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CVS Is Said to Agree to Buy Aetna

nytimes.com

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Re: CVS Is Said to Agree to Buy Aetna

#81

Post by untog »

allenz wrote: post #67

I see this as a move towards providing cheap basic medical care. This is timely now that it's possible that the individual mandate will be repealed. Millions of uninsured people could be treated for rashes or flus by nurses at CVS cheaper and faster than at doctor's offices. More competition in healthcare could be a good thing--many say it's bloated and overpriced. The risk is that poor people get basic care while ri…

How does CVS buying Aetna allow for "more competition"? I'm a lot more concerned that before we know it non-Aetna insurance customers will have difficultly or increased cost fulfilling a prescription at CVS stores.

I'm not sure what Aetna brings to the table in regard to a future where nurses fill CVSes, either. That seems like it would be a far bigger operation than buying Aetna, and the two would be only tangentially related.

Re: CVS Is Said to Agree to Buy Aetna

#82

Post by mythrwy »

ch4s3 wrote: post #11
winslow wrote: post #6

Earlier quoted context omitted.

Could you elaborate?

Engineer's Disease refers to specialists in one field assuming that they can speak with authority some other unrelated field. Healthcare in the US is notoriously complex and complicated, it would be naive to assume Amazon's success in distribution, ecommerce, and cloud services would necessarily translate to health care.

Complex and complicated is an understatement. It's a complete mess with a lot of very greedy unscrupulous people involved.

A lot of times the "care" people get is really crappy also, in spite of expensive insurance. Oh, but they'll be sure to offer you a $30 orange juice. Then you'll be getting bills for months/years afterwords and not be completely sure what they are for.

I realize medicine is a specialty. I realize it takes a lot of training to be a doctor. But I've always believed that a lot of what medicine solves isn't unknowably esoteric. A lot of it can be solved by a person with some hands on experience and good observational powers and base knowledge (not brain surgery obviously but things like yeast infections, simple broken bones, etc.).

The whole thing really is more ripe for disruption than any other area I can think of.

Re: CVS Is Said to Agree to Buy Aetna

#83

Post by afpx »

jrnichols wrote: post #76
allenz wrote: post #67

I see this as a move towards providing cheap basic medical care. This is timely now that it's possible that the individual mandate will be repealed. Millions of uninsured people could be treated for rashes or flus by nurses at CVS cheaper and faster than at doctor's offices. More competition in healthcare could be a good thing--many say it's bloated and overpriced. The risk is that poor people get basic care while ri…

> treated for rashes or flus by nurses I sometimes think that's one of the things that's kept health care so expensive. Nursing salaries aren't cheap. A lot of the home health and basic clinic stuff could be handled by an LPN/LVN or even a Paramedic in many cases. Not everything needs an RN. There are plenty of available telemedicine options to put a provider in touch with a higher level of care if necessary.

Or, the high price may be from administrative costs:

http://www.nejm.org/doi/full/10.1056/NEJMp1209711

Re: CVS Is Said to Agree to Buy Aetna

#84

Post by pcurve »

wbl wrote: post #63
dd36 wrote: post #59

Earlier quoted context omitted.

That’s only if MC has huge margins, which is doubtful. They already have to negotiate with every carrier.

Vertical integration cuts costs.

costing savings isn't as immediate or apparent as horizontal merger, otherwise more companies would be doing it. Perhaps it makes more sense in space where there are fewer players, but in healthcare as an overall pie is huge.

Re: CVS Is Said to Agree to Buy Aetna

#85

Post by maxerickson »

jrnichols wrote: post #76
allenz wrote: post #67

I see this as a move towards providing cheap basic medical care. This is timely now that it's possible that the individual mandate will be repealed. Millions of uninsured people could be treated for rashes or flus by nurses at CVS cheaper and faster than at doctor's offices. More competition in healthcare could be a good thing--many say it's bloated and overpriced. The risk is that poor people get basic care while ri…

> treated for rashes or flus by nurses I sometimes think that's one of the things that's kept health care so expensive. Nursing salaries aren't cheap. A lot of the home health and basic clinic stuff could be handled by an LPN/LVN or even a Paramedic in many cases. Not everything needs an RN. There are plenty of available telemedicine options to put a provider in touch with a higher level of care if necessary.

The Minute Clinics are staffed by nurse practitioners and physician assistants

https://www.cvs.com/minuteclinic/why-choose-us/our-practitio...

To expand their services to all of their stores, they'd be looking at hiring 5 or 10 percent of the NPs and PAs in the country.

Re: CVS Is Said to Agree to Buy Aetna

#86

Post by Consultant32452 »

quadrangle wrote: post #31
dr_ wrote: post #21

Earlier quoted context omitted.

I can attest to the fact that Aetna does cover flu shots now.

Flu shots are required to be covered in all U.S. insurance per the ACA. The point was that Aetna was requiring the more expensive (for them!) visit to a doctor's office for them to cover it and wouldn't cover it happening at a pharmacy.

The ACA states that your insurance provider must spend 80% of their premiums on health care. The doctor is more expensive, so the health insurance provider is allowed to keep more nominal dollars.

Re: CVS Is Said to Agree to Buy Aetna

#87

Post by Consultant32452 »

greenyoda wrote: post #57
rgbrenner wrote: post #54

Earlier quoted context omitted.

probably not more expensive for them... to go to your doctors office, you need to make an appointment, take time off work, etc. To go to a pharmacy, you can stop by on your way home or do it on the weekend. By making it inconvenient, you reduce the number of people getting a flu shot... and I would bet that more people drop out from the inconvenience, than the extra amount it costs aetna when you go to the doctors of…

But if just one of the people insured by Aetna ended up in the hospital due to complications from the flu due to not getting a flu shot, the amount of money they'd have to pay for the hospital stay would pay for hundreds of flu shots.

The insurance provider doesn't care how much it costs. The ACA states that the insurance provider must spend 80% on services. So as far as they're concerned, the higher the costs of healthcare the more money they get to keep. They just can't let costs skyrocket faster than they're able to increase your premiums.

Re: CVS Is Said to Agree to Buy Aetna

#88

Post by chimeracoder »

Flammy wrote: post #66
chimeracoder wrote: post #61

Earlier quoted context omitted.

> IF you want to disrupt the pharma market, just let drug importation go free, Yup. Allowing reimports of prescription drugs would be the single easiest way to have a massive effect on the costs of care in the US, with pretty much no negative impact on patients, providers, or pharmaceutical companies in the US.

How would that not significantly harm the pharmaceutical companies? Don't they make a decent percentage of their revenue off of brands which are currently price protected via these tariffs?

> How would that not significantly harm the pharmaceutical companies? Don't they make a decent percentage of their revenue off of brands which are currently price protected via these tariffs?

As lostapathy explained below, US prices are currently high because that's where pharmaceutical companies are capturing their profits. In fact, even European pharmaceutical companies make most of their revenue from sales in the US, not Europe. (This is why the US funds over 50% of R&D for the entire world, even though it only has 300 million people, and many of the largest pharmaceutical companies are based in Europe, not the US).

If reimportation were permitted[0], pharmaceutical companies would adjust the prices of drugs across those countries, which would bring drug prices in the US and Europe in line with one another.

Ultimately, pharmaceutical companies would still be able to make the same amount of money off the drugs, but it would distribute the sources of that money more evenly across the people who are actually using the drugs (and benefiting from the research and development).

[0] it would almost certainly only apply to reimports of drugs from other NATO countries (more or less), because those are the countries that abide by US patent law on drugs (India and China, by contrast, do not recognize US patent law on large classes of drugs),

Re: CVS Is Said to Agree to Buy Aetna

#89

Post by allenz »

untog wrote: post #81
allenz wrote: post #67

I see this as a move towards providing cheap basic medical care. This is timely now that it's possible that the individual mandate will be repealed. Millions of uninsured people could be treated for rashes or flus by nurses at CVS cheaper and faster than at doctor's offices. More competition in healthcare could be a good thing--many say it's bloated and overpriced. The risk is that poor people get basic care while ri…

How does CVS buying Aetna allow for "more competition"? I'm a lot more concerned that before we know it non-Aetna insurance customers will have difficultly or increased cost fulfilling a prescription at CVS stores. I'm not sure what Aetna brings to the table in regard to a future where nurses fill CVSes, either. That seems like it would be a far bigger operation than buying Aetna, and the two would be only tangential…

I agree that CVS wants to stave off Amazon and mail order pharmacies. But a buyout is an expensive way to secure a fraction of the market.

Buying Aetna makes it easier to expand the new Minute Clinic business model. CVS no longer has to worry about getting paid less than a hospital for treating a cough or fever. Aetna could even charge zero copay for nurse visits. It's more competition in the "basic healthcare" space (if it happens).

Re: CVS Is Said to Agree to Buy Aetna

#90

Post by chimeracoder »

sithadmin wrote: post #74
Flammy wrote: post #66

Earlier quoted context omitted.

How would that not significantly harm the pharmaceutical companies? Don't they make a decent percentage of their revenue off of brands which are currently price protected via these tariffs?

>Don't they make a decent percentage of their revenue off of brands which are currently price protected via these tariffs? Yes. If consumers and/or pharmacies in the US could easily and reliably source cheaper brand-name drugs from international markets where price ceilings are in effect, it would ruin many drug companies, especially smaller ones.

> Yes. If consumers and/or pharmacies in the US could easily and reliably source cheaper brand-name drugs from international markets where price ceilings are in effect, it would ruin many drug companies, especially smaller ones.

Those price ceilings only exist because of the artificial trade barrier between the US and those other countries. Without that trade barrier, pharmaceutical companies would charge roughly equivalent prices in the US and other countries. It wouldn't ruin drug companies at all.

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